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单次和多次产前糖皮质激素暴露对早产新生羔羊心血管和肾功能的改善作用相似。

Single and multiple prenatal glucocorticoid exposures improve preterm newborn lamb cardiovascular and renal function similarly.

作者信息

Smith Lynne M, Ervin M Gore, Wada Norihisa, Ikegami Machiko, Jobe Alan H

机构信息

Department of Pediatrics, University of California, Los Angeles School of Medicine, Harbor-UCLA Medical Center, Torrance 90502, USA.

出版信息

Am J Obstet Gynecol. 2003 Feb;188(2):444-53. doi: 10.1067/mob.2003.36.

Abstract

OBJECTIVE

Renal and cardiovascular function improves in preterm newborn lambs after a single prenatal betamethasone treatment. We hypothesized that multiple betamethasone exposures would further improve renal and cardiovascular adaptation.

STUDY DESIGN

Pregnant ewes were chosen randomly to receive saline solution, one dose of 0.5 mg/kg betamethasone at 104 days of gestation, or three doses of 0.5 mg/kg betamethasone at 104, 111, and 118 days of gestation. Lambs were delivered at 125 days of gestation (preterm) or 145 days of gestation (term). Renal and cardiovascular responses to phenylephrine were evaluated at 2 hours of age.

RESULTS

The preterm single and multiple betamethasone-treated lambs comparably increased glomerular filtration rate, urinary flow and osmolar clearance, and sodium excretion in response to phenylephrine. Term responses were similar and not influenced by betamethasone exposure.

CONCLUSION

Multiple courses of betamethasone do not further improve renal and cardiovascular responses from a single betamethasone dose. Renal and cardiovascular function at term is not affected by early prenatal betamethasone exposure.

摘要

目的

对早产新生羔羊进行单次产前倍他米松治疗后,其肾脏和心血管功能会有所改善。我们假设多次暴露于倍他米松会进一步改善肾脏和心血管的适应性。

研究设计

随机选择怀孕母羊,分别给予生理盐水、在妊娠104天时给予一剂0.5毫克/千克的倍他米松,或在妊娠104天、111天和118天时给予三剂0.5毫克/千克的倍他米松。羔羊在妊娠125天(早产)或145天(足月)时分娩。在出生2小时时评估对去氧肾上腺素的肾脏和心血管反应。

结果

早产的单次和多次倍他米松治疗的羔羊对去氧肾上腺素的反应中,肾小球滤过率、尿流量和渗透清除率以及钠排泄量均有类似增加。足月时的反应相似,且不受倍他米松暴露的影响。

结论

多次给予倍他米松不会比单次剂量的倍他米松进一步改善肾脏和心血管反应。产前早期暴露于倍他米松不会影响足月时的肾脏和心血管功能。

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